Background: Moral sensitivity is a key component of ethical nursing practice, enabling nurses to recognize and address ethical challenges in patient care. Although several Iranian studies have examined nursing students’ moral sensitivity, their findings remain inconsistent. This systematic review and meta-analysis aimed to estimate the overall level of moral sensitivity among Iranian undergraduate nursing students.
Methods: A systematic search was conducted in PubMed, Scopus, Web of Science, CINAHL, SID, and Google Scholar from inception to February 8, 2025, using terms related to “moral sensitivity” and “nursing students.” The primary measurement instrument was Lützén’s Moral Sensitivity Questionnaire (MSQ).
Results: The meta-analysis pooled findings from multiple studies on Iranian undergraduate nursing students. The pooled mean moral sensitivity score was 61.33 (95% CI: 53.35–69.31), indicating a moderate level. Subgroup analysis showed no significant differences by gender or risk of bias. High heterogeneity was observed (I² = 100%). After adjusting for publication bias, the mean increased to 85.44. Moral sensitivity was highest in rule-based domains and lowest in moral meaning and benevolence.
Conclusion: Iranian nursing students demonstrate moderate moral sensitivity. While they can identify ethical conflicts, they face challenges in moral reasoning and benevolence. In clinical care, enhancing moral sensitivity is crucial for safer, patient-centred care through improved recognition of ethical issues, respect for privacy, equitable practice, and timely advocacy. These findings suggest the need for integrating longitudinal ethics education and interdisciplinary ethics rounds into nursing curricula to strengthen moral judgment and decision-making.